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     [                         Registration Form                            ]
     [                                                                      ]
     [   Date: __________                    TO:  Ralph LoBianco            ]
     [                                            Suite #231                ]
     [                                            7143 State Road 54        ]
     [                                            New Port Richey, FL 34653 ]
     [                                                                      ]
     [   FROM:     Name: ________________________________________           ]
     [                                                                      ]
     [          Address: ________________________________________           ]
     [                                                                      ]
     [                   ________________________________________           ]
     [                                                                      ]
     [                   ________________________________________           ]
     [                                                                      ]
     [     BBS Name ______________________________________________          ]
     [                                                                      ]
     [     Modem Type/Max Baud Rate ______________________________          ]
     [                                                                      ]
     [     BBS Phone # (_____)_________________________                     ]
     [                                                                      ]
     [     Voice Phone # (_____)_______________________                     ]
     [                                                                      ]
     [   PROGRAM NAME:______________  VERSION:___________________           ]
     [                                                                      ] 
     [   WHERE DID YOU GET IT: __________________________________           ]
     [                                                                      ]
     [   IF BBS, NAME & PHONE: __________________________________           ]
     [                                                                      ]
     [   COMMENTS:_______________________________________________           ]
     [                                                                      ]
     [   ________________________________________________________           ]
     [                                                                      ]
     [   ________________________________________________________           ]
     [                                                                      ]
     [   ________________________________________________________           ]
     [                                                                      ]
     [   ________________________________________________________           ]
     [                                                                      ]
     [                                                                      ]
     [             SETED  Registration Fee....... _ $5.00___                ]
     [                                                                      ]
     [             FL residents add sales tax .... __________               ]
     [                                                                      ]
     [             Total Enclosed ................ __________               ]
     [                                                                      ]
     [                                                                      ]
     [         Please DO NOT send cash.  Send check or money order.         ]
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